Veterinary surgeons

A general practice (GP) veterinarian is the jack-of-all-trades of the veterinary world. Often, these veterinarians see patients from the day the pet is born to the end of life. They see more than one species. They typically perform the tasks of many professionals, caring for medical, surgical, and dental issues. General practice veterinarians have a great range of knowledge, somewhat similar to a family medicine physician.

On the other end of the spectrum are specialist veterinarians. Often, these veterinarians are board-certified, having had several additional years of education to become very good in a single subject. Specialists often see all ages and multiple species but focus on one distinct area of veterinary medicine, such as dermatology, surgery, dentistry, or emergency medicine. This focus allows them to become very good in their area of practice. The specialists' deep knowledge is similar to physicians specializing in one subject, such as endocrinologists or neurosurgeons.  

Occasionally, there are GP veterinarians who are like specialists because they are very good at a specific subject or task, but they are not board-certified, often because board certification does not exist in that particular area of veterinary medicine. An example of this is high-quality, high-volume spay/neuter surgeons. These surgeons are incredibly skilled at performing spays and neuters on a wide variety of breeds and ages quickly and with a very low complication rate.
For the sake of simplicity here, these veterinarians will be included with the board-certified specialists.

Why Would My Veterinarian Refer My Pet to a Specialist?

A GP veterinarian makes a referral when they feel that a specialist can better serve their patients’ needs. Some reasons for a referral might be because your GP:

•  feels the patient’s case is very complex, or the GP has not been able to make a diagnosis;
•  has exhausted their knowledge of the disease process and/or treatment options;
•  does not have much experience with a particular disease or procedure;
•  does not have the specialized skills or equipment needed to provide the best care for the patient;
•  cannot provide the around-the-clock care needed for the patient;
•  does not have enough staff or does not have staff with the right skills to care for the patient properly; or
•  does not enjoy a particular procedure or treating a specific disease and feels that someone specializing in that care will do it better.

By making the referral, the GP veterinarian is making the care of your pet the top priority.

Do I Always Have to Go to Another Clinic for Specialty Care?

No. With the advent of telemedicine, sometimes a GP veterinarian can get the input of specialists without the patient leaving the clinic. Having a radiologist review X-rays or ultrasound images can often be done simply by sending the digital images over the Internet. Sometimes, veterinarians can get input from specialists by posting the patient’s case to veterinary online forums such as the Veterinary Information Network (VIN), where they can get input from one or more specialists. Traveling specialists, such as a surgeon, ultrasonographer, or internist, will come to the GP veterinarian’s clinic to provide services. Additionally, many laboratories offer phone consultations with specialists to the veterinarian who ordered the test.

If I Accept a Referral, Who Is in Charge, the GP or the Specialist?

Your time with the specialist may entail a single appointment or multiple appointments over an extended period. The GP and specialist veterinarian keep in touch with each other to provide appropriate care and to determine the best next steps for your pet. Your GP veterinarian will still be there to take care of any of your pet’s needs outside of those provided by the specialist, such as annual examinations and routine vaccinations.

So Why Do Clients Sometimes Decline Specialty Care?

Often, clients perceive specialty care as being more expensive than care offered by general practices, which is sometimes true. Specialty care can cost more initially but may save more in the long run by getting a faster diagnosis with fewer tests and treatments not available from the GP veterinarian. Less time can be spent at the specialty clinic while your pet receives more direct care. It’s possible the specialist will perform a consultation (an initial examination of your pet followed by a discussion with you) without having to do more diagnostics or send home new medications. The specialist may be able to send you back to your GP veterinarian and guide them on the best next steps for your pet.

For example, say your Italian greyhound (if you’re not familiar with this breed, think of a tiny greyhound with the weight of a cat) breaks a leg near the elbow. Some fractures are much easier to repair than others. When the patient is small, or the fracture is near a joint, they can be much more difficult.

Specialized tools and supplies are often involved. While your GP may be able to do the repair, it’s quite likely a board-certified veterinary surgeon could do it faster and possibly better. The surgeon usually has advanced education, skills, experience, and equipment, all of which add to the speed of the procedure. Additionally, the staff may be better prepared because they only work with surgical patients and are better equipped to address the sometimes challenging anesthetic needs of sighthounds such as Italian greyhounds. All this can result in a shorter anesthetic time. This can mean a less expensive procedure than if the GP veterinarian had done it.

This speed, skill, and specialized equipment may improve your pet's outcome. It’s not that your GP veterinarian can’t do it – some are great at advanced surgical procedures (or advanced dentistry, specific chronic diseases, etc.) and enjoy it. It’s that they may feel your little dog will be better served by a specialist, and there will be less chance of post-operative complications. 

Again, your GP veterinarian is putting the care of your pet above all else.

Other reasons for not seeing a specialist may include the distance to the specialty practice (specialists are often not found in more rural areas), an inability on the part of the owner to travel to the specialist, or, these days especially, a long delay before your pet can be seen. Finally, there is the possibility that an owner simply doesn’t want to see that particular specialist for whatever reason.

General practitioner veterinarians do not make referrals lightly. They are aware of their clients’ concerns about costs, travel, and more.

When your general practice veterinarian refers your pet to a specialist, understand your veterinarian is trying to provide the best for you and your pet.